- Update on the Neurobiology of Alcohol Withdrawal Seizures

The severity of alcohol withdrawal symptoms progressively increases over years of alcohol abuse, and repeated detoxifications augment the likelihood of alcohol withdrawal seizures (8384). Similarly, studies in rodents have shown that repeated alcohol withdrawal experiences increase the severity and duration of subsequent withdrawal seizures (8586). These observations have led to the view that alcohol withdrawal causes permanent epileptogenic changes in brain systems relevant to ethanol withdrawal seizures—a type of kindling phenomenon. Indeed, in accordance with the central role of the IC in triggering alcohol withdrawal seizures, multiple alcohol withdrawal episodes in rats facilitate the development of IC kindling (8788). There is no recognized treatment to slow or prevent this kindling process. In animals, benzodiazepines have yielded variable effects, in some cases slowing withdrawal-induced kindling, and in other cases, causing paradoxical worsening (656689). Whether other agents used in the treatment of alcohol withdrawal have antiepileptogenic potential remains to be determined.